Headache by Dudley Fulton, M. D.

Review and Herald Publishing Association · Tacoma Park Station, Washington, D. C. · Sep 22, 1910

Headache

By Dudley Fulton, M. D.

DUDLEY FULTON, M. D.

Headache is one of the commonest symptoms of disease. Fifteen per cent of schoolchildren, twenty-five per cent of men, and more than fifty per cent of women suffer from it. It is one expression of the functional disturbance of some organ of the body. As such, like all symptoms, it is useful, even though painful, because it is essentially a warning of that which is worse than itself.

There is scarcely a disease of which headache may not constitute a symptom, and it is this very fact which renders its study important and interesting. Thus, headache stands in causal relation to disease of the eye, ear, nose, throat, teeth; and its proper interpretation demands, therefore, a knowledge of all these. It is further intimately related to disorders of the digestive system and to disease of the kidneys; to a morbid state of the blood, such as anemia, autointoxication, high blood tension; and to such maladies as gout and rheumatism. In searching, therefore, for the cause of headache, we must be prepared to look for it in every possible direction.

The headache age is from fifteen to fifty-five, early childhood and declining age being usually exempt. Headache is more frequently found in city populations and among the wealthier classes. It is more common in the spring and fall, and in temperate climates.

Types of Headache

Broadly speaking, there are six types of headache,—congestive, anemic, toxic, neuralgic, nervous, and organic. There is another important form of head-pain, migraine, the classification of which is somewhat doubtful. Headache may be classed in accordance with the kind of pain, which differs with different persons and with different causes. We have (1) pulsating, throbbing headache; (2) dull, heavy headache; (3) constrictive, squeezing, pressing headache; (4) hot, burning, sore sensation. The first form characterizes disturbance of the circulation—congestion and anemia; the second is usually of the dyspeptic or toxic type; the third is found in the nervous individual; the fourth, in the rheumatic or anemic. The underlying condition of congestive headache is explained in the term “congestion,” and is an engorgement of the blood-vessels within the cranial cavity. This increases the pressure upon the structures of the bony chamber. The seat of pain in headache is in the scalp and the coverings of the brain. The brain substance itself is probably not sensitive to pain, as portions of it may be cut or torn away without pain to the individual.

A congestive headache is accompanied by a flushed condition of the face and neck, by congested eyes, throbbing of the temporal arteries, dread of light, and some dizziness. Coughing, lowering of the head, as in stooping over, or anything that increases the flow of blood to the head, increases the pain.

Successful Treatment

A patient recently under observation suffered the foregoing symptoms. Sleep, especially in the recumbent position, had been impossible for weeks, being induced only when the patient was propped up with pillows. Lowering the head increased the pain. Immediate relief followed the institution of correct treatment. Headache powders, which by increased dosage had kept the patient temporarily comfortable, were withdrawn. The head and neck were wrapped in towels wrung from cold water. This contracted the blood-vessels of the head and neck, thus reducing the current of blood to the head. At the same time hot-blanket packs were applied to the legs, this measure dilating the blood-vessels, and increasing the amount of blood in these parts. Thus by revulsion the head was relieved of the excess blood. Sweet sleep invariably followed this proceeding. Correction of the dietetic errors, improved action of the bowels, needed rest, and tonic baths removed the tendency to headaches.

Another patient was relieved by an opposite plan of treatment. His headache was caused by anemia, or lack of blood in the head, the tissues of which were poorly nourished. The face, lips, and mucous membranes of the mouth and eyes were pale and lusterless. The patient was thin and emaciated. When in the standing or sitting posture, he suffered severely from headache. He had learned that he suffered less when sleeping without a pillow. Advantage was taken of gravity by elevating the foot of the bed, thus allowing a free flow of blood to the patient’s head. Warm compresses were applied to the head and neck to encourage the flow of blood to these parts. Tonic measures, such as centripetal massage and electricity, relieved him completely of the symptom.

Sick Headache and Neuralgia

Bilious headache, or sick headache, means a sick stomach. Because of overeating or too frequent eating, or because of eating indigestible food, decomposing masses of food lie in the stomach, poisons are generated, and chemical combinations are formed, which, absorbed into the general circulation, irritate the nerve-endings in the head and elsewhere, producing pains and aches. Fasting a day, washing out the stomach, or living on an exclusive fruit diet for a day or two, will dispose of this headache. The cure follows temperance and good judgment at the dinner table.

Neuralgic headaches are usually localized to one spot or to the course of a nerve. Those having a tendency to rheumatic and gouty disturbances are most liable to this form of head-pain. It yields stubbornly to treatment when the blood becomes saturated with uric acid from a diet excessively rich in nitrogen, or because the eliminating organs of the body are sluggish and overworked, and unable to dispose of the sewage of the system. Most often applications of heat, electricity, and light rubbing give temporary relief. Cure depends upon the restoration of the normal equilibrium of the income and output of the nitrogenous elements of food,—lessening the income by limiting the diet to well-cooked cereals, vegetables, and abundance of fruit; and increasing the output by flushing the tissues and kidneys by drinking two or three quarts of pure water daily, by physical exercise to the point of free perspiration, by morning cold baths, and by eliminative hydropathic procedures to increase the activity of the skin.

Drugs powerful enough to deaden the pain are detrimental. They in no sense cure, as they do not remove the cause, nor do they place the body in a condition where it can more easily cope with disease processes; hence they should be left in the chemist’s shop, the only fit place for them.

Nervous Headache

Nervous headaches select the back of the head and neck. More often the abnormal sensation is of weight, pressure, constriction about the head, heaviness, fulness, or numbness, rather than pain or ache. Usually it is most evident mornings, less so or absent during the latter part of the day. With it generally goes fatigue, either mental or physical, or both, upon ordinary exertion. Loss of sleep, or sleep which fails to refresh, and diminished weight, are common concomitants.

Such a group of symptoms indicates pathological fatigue. The head sensations disappear upon the adoption of those measures which check the nerve leaks, and remove the causes producing them. Rest-cure, either complete or partial, may be necessary. A diet of maximum nourishment, requiring minimum

effort to digest it, is indicated. Tonic, passive exercise, in massage and manual and mechanical Swedish movements, is beneficial.

Organic Headache

It may be said that the foregoing functional headaches do not, as a rule, prevent sleep. Organic headaches do. The constancy of organic headache and the inability to relieve it permanently by known rational measures, coupled with violent vomiting unaccompanied by nausea, and failure of vision, suggest grave mischief within the cranial cavity in the form of tumors, abscess of the brain, etc. Such cases require surgical interference. Fortunately, organic headaches are most rare.

Migraine

Head-pain which appears early in life; which appears at regular or irregular periods, varying from a few days to weeks or even months apart; and which is preceded an hour or a day by warning of the attack, most often by blurred sight, or circles of different colored lights, suggests migraine. The pain, which is usually limited to one side of the head, is so excruciating as totally to incapacitate the individual. Dread of light is common. Nausea and vomiting end the attack in from one to four days. Two or three days before and after the attack of migraine, the patient feels unusually well. Many individuals have an inherited predisposition to migraine, but may remain quite free from it until some reflex cause, like indigestion, eye-strain, the retention of body poisons, or general ill health, brings on an attack. The prospects of cure depend upon the removal of the reflex cause or causes. Careful body training, dieting, and those measures which increase the capacity of the body to resist disease, cure more cases than other procedures.